A multifaceted approach to wellness in a hematology/oncology fellowship program.
Authors: Thejal Srikumar, Norin Ansari, Kristina Fanucci, Sarah B. Goldberg, Michael E. Hurwitz, Nikolai Alexandrovich Podoltsev, Alfred Ian Lee, Tara B. Sanft
Journal: Journal of Clinical Oncology (2023)

11006 Background: Burnout is widespread among physician trainees and is a growing problem despite increasing awareness. We describe multiple efforts in a single institution’s Hematology/Oncology (HO) fellowship program to help support trainees’ wellness. Methods: A needs assessment was conducted to identify wellness topics and programming important to fellows. Anonymous surveys were distributed to all fellows in Yale’s HO fellowship program at the start of the academic year. Three senior fellows reviewed the results and, with the support of core faculty, designed initiatives to address top priorities. The interventions included off-campus debrief sessions for fellows only, Schwartz Rounds-style discussions during weekday didactic slots, faculty-led didactics on Imposter Syndrome and Perfectionism, and several off-campus, after-hours social activities. A follow-up survey was conducted six months after the initial survey (mid-academic year) to garner feedback. Results: Of the 23 fellows who were sent the initial survey, 17 responded (73.9%). The most requested discussion topics were Perfectionism Traps, Imposter Syndrome, Achieving Happiness/Defining Success at Work, and Myths About Work/Life Balance. Most fellows (76.5%) responded that they would attend off-site debrief sessions if offered. In response to the initial survey, several initiatives were undertaken as described in Methods. The mid-year survey was completed by 16 of 23 fellows (69.6%). Of these 16 respondents, attendance was as follows: 31.3% for after-hours debrief sessions, 75% for Schwartz Rounds-style discussion, 75% for Imposter Syndrome and Perfectionism lecture, and 75% for at least one social activity. The majority of fellows who attended these events reported them to be helpful (range 75-100%). Themes identified from written comments included universal appreciation for wellness programming efforts and a desire for more sessions for group reflection. One fellow noted these activities were “helpful for wellness and fostering a pleasant work environment.” Other fellows noted the Imposter Syndrome discussion “should be mandatory” and “would be helpful earlier in the year.” Several fellows expressed their wellness was linked to clinical workload, and one fellow noted sessions outside of regular work hours are difficult to attend. Conclusions: Structured needs assessment and implementation of wellness programming in a HO training program appeared to be beneficial to the majority of fellows. To our knowledge, this is the first description of comprehensive fellow-directed wellness initiatives in HO training. Continued efforts must be made to better support fellows, including options in location, timing, faculty presence, and optimizing work responsibilities and expectations. Further study is necessary to quantify the impact of these initiatives and to tailor the most effective approach to fellows’ wellness.